what sites should be avoided when performing venipuncture quizlet

\u00a9 2023 wikiHow, Inc. All rights reserved. Select the proper approved lancet: The BD Microtainer Contact-Activated. Venipuncture (sometimes referred to as venapuncture, venepuncture or even venu puncture) is the collection of blood from a vein which is usually done for laboratory testing. are known to vary lab results of some analytes. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. Loosen the tourniquet. Discarding the first set minimizes the effects of any potential additive contamination. After cleansing, allow the venipuncture site to air dry. Any microtainerscontaining additives should be tapped to dislodge additives from the walls and top. C. placed in the sharps container If another site is not available, collect the specimen distal to the hematoma. Never draw over scars or a new tattoo sites. 7. The first step to choosing the right vein is to select the appropriate needle gauge. Procedures and Devices for the Collection of Diagnostic Capillary Blood. -Vacutainer barrel This requisition form must contain the proper information in order to process the specimen. Lippi G, Salvagno GL, Montagnana M, Franchini M, Guidi GC. The recommended order of draw for plastic collection tubes is: First - blood culture bottle or tube (yellow or yellow-black top). The puncture should be made perpendicular to the ridges of the fingerprint so that the drop of blood does not run down the ridges. Dorsal hand veins are often utilized for intravenous infusions but are viable options for blood draw sites. Tubes with different additives are used for collecting blood specimens for specific types. Capillary specimens are collected in microtainers with colored caps that are used to. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. To prevent hemolysis (which can interfere with many tests): Mix tubes with anticoagulant additives gently 4-6 times, Avoid drawing the plunger back too forcefully, if using a needle and syringe, or too small a needle, and avoid frothing of the sample. Cleanse the fingertip of the 3rd (middle) or 4th (ring) finger with an alcohol prep. The median cubital creates, The dorsal venous network is the next most common vein site for phlebotomists. 6. Have the patient hold a small gauze pad over the puncture site for a couple of minutes to stop the bleeding. In some cases, a phlebotomist may have to switch sites if they find the blood is not properly flowing from the vein. The patient has the right to refuse participation in such activity. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. A. the tubes are filled and properly labeled Occupational Safety and Health Administration, United States Department of Labor. advantageous in certain adult populations, such as: those with severe burns, obese patients, those with thrombotic tendencies, and for point-of-care testing, when a small volume of blood is needed. Please enable cookies on your browser and try again. Specimens from infants under the age of 6 months are typically collected by heelstick. Deliver specimens promptly to the laboratory. var prevIframeHeight = iframe.style.height; Mix and label all appropriate tubes at the patient bedside. Have the patient position their arm on the armrest. Proper labeling procedures and completion of laboratory requisitions. Not making it mobile friendly. Warning: Do not make lateral (side-to-side) movements with the needle. 6. Clean the site to be punctured with an alcohol sponge. Blood is commonly obtained from the median cubital vein on the anterior forearm. Allow another large drop of blood to form. (c) How would you prepare tetracaine from benzene? Allow the blood to soak through and completely fill the pre-printed circle on the filter paper. The patient who is at ease will be less focused on the procedure. Significant increases can be found in total protein, aspartate aminotransferase (AST), total lipids, cholesterol, iron, Affects packed cell volume and other cellular elements. Blood clots, and the serum is separated by centrifugation, Chemistries, Immunology and Serology, Blood Bank (Crossmatch), Serum separator tube (SST) contains a gel at the bottom to separate blood from serum on centrifugation, Plasma Separating Tube (PST) with Lithium heparin, Anticoagulates with lithium heparin; Plasma is separated with PST gel at the bottom of the tube, Hematology (CBC) and Blood Bank (Crossmatch); requires. The patient should make a fist without pumping the hand. What are the gold top containers used for? These items include: Clin Biochem. What caution should you observe when using a Vacutainer? Reasonable informed participation in decisions involving the patient's health care. You will be redirected once the validation is complete. To determine the best vein, use both sight and touch. The hydrostatic pressure causes some water and filterable elements to leave the extracellular space. Joslin JO. What should you do with a CBC or lavender top tube before putting them down? Assess the patient's physical disposition (i.e. Thrombosed veins lack resilience, feel cord-like, and roll easily. 1. -obvious skin infection (including newly tattooed areas) -extensive scarring -don't use same side as mastectomy -avoid previous hematoma -avoid arm w/ fistula/cannula -edamtous extremity What is the most common site for blood sampling? 2. If multiple blood samples are to be taken, the phlebotomist must be careful to follow the proper order of draw. When wearing gloves, change them between each patient and wash your hands frequently. Document that the venipuncture was performed distal to (below) an infusion site. Cochrane Database Syst Rev. The patient should either sit in a chair, lie down or sit up in bed. A 21-gauge needle (e.g. -antiseptic swabs Position the patient with the arm extended to form a straight-line form shoulder to wrist. proteins). Tip: BD Vacutainer tubes use a translucent stopper to identify short draw variants. The first attempt is the antecubital fossa area, starting with the median cubital vein, then the cephalic vein, and the basilic vein. Consult a specialist at the patient's own request and expense. This image may not be used by other entities without the express written consent of wikiHow, Inc.
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\n<\/p><\/div>"}, 7 Easy Ways to Figure Out Your Blood Type (With or Without a Test). Never draw from a thrombosed or scarred vein. The median cubital vein and the cephalic vein in the wrist area should be avoided when possible. Predict a possible value of the thickness of the soap bubble. Adhesive bandages / tape - protects the venipuncture site after collection. 1. Avoid drawing blood from a hematoma; select another draw site. Tip: Patients who need regular bloodwork (e.g. List six areas to be avoided when performing venipuncture and the reasons for the restrictions. The maximum number of times an individual should attempt a venipuncture on a patient is two, True or False? A. Edema apply pressure for at least 10 minutes. 1. A. EMLA (See Use of Band-Aids in the Post Phlebotomy. Dispose of contaminated materials in appropriate waste receptacles. When would you use a butterfly/infustion set? www.mlo-online.com is using a security service for protection against online attacks. Choosing an appropriate site for venipuncture is crucial for a successful . Use a smaller tube with less vacuum. f.style.height="352px"; These may include listening to music or a story, watching a video, playing with a toy, having a parent provide distraction with talk or touch, using flash cards, and squeezing a rubber ball. doi: 10.1002/14651858.CD005179.pub3. (See, The chlorhexidine is a concern for the premature babies in NICU as it can, be absorbed through the skin. Cannula/fistula/heparin lock - hospitals have special policies regarding these devices. When do you release the tourniquet during venipuncture? Any attempt to repeat a puncture at the same site increases the risk of complications. Needles should be placed in a proper disposal unit IMMEDIATELY after their use. Allow to air dry. Extensive scarring or healed burn areas should be avoided Specimens should not be obtained from the arm on the same side as a mastectomy. This type of venipuncture procedure is a little different, and sometimes can be a little more involved. HealthStar Press, Inc. 2001, updated 1/08. Inadvertently nicking a nerve causes intense pain. 3. The equipment used during the venipuncture test can vary, but the following are most commonly used for routine venipuncture: Phlebotomists may choose to draw blood from several different sites of the body. Avoid areas of hematoma. What are some of the reasons to draw blood? Performing a venipuncture on a child under one year of age . What is the most common complication of venipuncture? At least two patient identifiers, such as name and date of birth, are needed. Ernst, Dennis J. This image may not be used by other entities without the express written consent of wikiHow, Inc.
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\u00a9 2023 wikiHow, Inc. All rights reserved. Also found in the antecubital fossa, the basilic vein serves as a last resort for blood draws. An assortment of needles and syringes of different sizes Tourniquet Alcohol and alcohol swabs Gauze or cotton balls Laboratory forms and blood-specimen labels Transportation bags and sharps container Step 2: Prepping The Patient Once you have the necessary supplies, it's time to ready the patient. Needles - The gauge number indicates the bore size: the larger the gauge number, the smaller the needle bore. 11. Wash hands in warm, running water with an appropriate hand washing product, or if notvisibly contaminated, with a commercial foaming hand wash product before and aftereach patient collection. Check the requisition form for requested tests, patient information, and any special requirements. You may also remove the tube, wait a few seconds for blood flow to resume, and then engage a short drawtube. Dispose of needles immediately upon removal from the patient's vein. If the blood flow is diminished, repeat the capillary PUNCTURE to complete the collection. Adjust the height and swivel the chair to ensure your body is in line with the vein. Additionally, blood samples should not be taken on an arm with a fistula used for dialysis treatments. A warm compress or heel warmer should be used to warm, fingers and heels that are cold, or if a capillary blood gas is being drawn, to. Elderly patients often have fragile skin and veins that roll quite easily, When a vein rolls, the needle tends to push the vein aside rather than penetrating through. -obvious skin infection (including newly tattooed areas). Green Grasp the patient's arm firmly using your thumb to draw the skin taut and anchor the vein. NOTE:Tubes with additives must be thoroughly mixed. 2013 Oct 10;(10):CD005179. Draw 5 ml of blood and discard before drawing the specimen tubes for testing. Interruptions and distractions during medical encounters and procedures should be avoided. Avoid UE on same side of mastectomy (lymphedema) The blood is normally drawn from a vein on the top of the hand or from the inside of the elbow. Serum iron levels tend to drop during the day. Never draw above an IV site. 8. To prevent hemolysis when performing a venipuncture, the phlebotomist should: 1. The content of this article is not intended to be a substitute for professional medical advice, examination, diagnosis, or treatment. Tip: If you realize you've collected in the wrong order of draw, remove the tube, insert the correct one, fill it halfway before discarding it, then insert a new tube and fill it completely. Larger tube sizes typically provide for collection of samples from 6 to 10 mL. By holding the needle either by the plastic wings or the hub, phlebotomists can achieve a shallower angle, typically 10-15 degrees. If an IV is in place, samples may be obtained below but NEVER above the IV site. Procedure for Capillary Puncture of the Finger: The best site for a finger puncture is just off the center of the finger pad of, the 3rd (middle) or 4th (ring) finger of the hand. Phlebotomy is the practice of drawing blood from patients to gather data about their health. Proper Handling of an Uncooperative Patient in an Outpatient Setting Akron. Check for any allergies to antiseptics, adhesives, or latex by observing for armbands and/or by asking the patient. A. just prior to needle insertion However, blood samples that are normally taken are actually very small. Expect that any discussion or consultation involving the patient's case will be conducted discretely and that individuals not directly involved in the case will not be present without patient permission. Drawing from these sites can cause blood clotting and hemostasis. It doesn't matter . Have an assistant stabilize the arm by firmly locking the elbow joint. It brings the entire family Similarly, it's quite easy to get lost in a "Wikipedia wormhole." Indeed, Wikipedia's depth is infinite, as you link from subject to subject, never able to stop. If using a syringe, make sure the needle is fitted securely on a syringe to avoid frothing. 9. When using a syringe inserted into the line, blood must be withdrawn slowly to avoid hemolysis. Switch to the other arm if you can't find anything. PROBLEMS OTHER THAN AN INCOMPLETE COLLECTION: A hematoma forms under the skin adjacent to the puncture site - release the tourniquet immediately and withdraw the needle. Source of specimen. Avoid trauma and excessive probing. 3. He holds a Diploma in Medical Laboratory Assistance and is certified under the British Columbia Society of Laboratory Science. chemistries, serology, immunnology, blood bank. If there is a concern regarding contamination by tissue fluids or thromboplastins, then one may draw a non-additive tube first, and then the light blue top tube. It is not uncommon for adults and children to feel some fear when having blood drawn, which is why any discussion of venipuncture should at least bring this topic to focus. Sometimes you may get initial blood flow, but then it stops when you change tubes. 4. Impact of Use of Smaller Volume, Smaller Vacuum Blood Collection Tubes on Hemolysis in Emergency Department Blood Samples. Sign up for wikiHow's weekly email newsletter. Automated systems may include labels with bar codes. Be sure to dispose of the lancet in the appropriate sharps container. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. B. Hematoma This image may not be used by other entities without the express written consent of wikiHow, Inc.
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\u00a9 2023 wikiHow, Inc. All rights reserved. Journal of Exotic Pet Medicine. Which of the following is the most likely mechanism for alteration in protein values in this situation? ACDA or ACDB (pale yellow top). 23-gauge needles (e.g. Approach the patient in a friendly, calm manner. Capillary Specimens may be collected on filter paper and sent to lab for testing for. A needle is then gently inserted into the vein. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. Apply the tourniquet approximately 4-5 finger-widths above the planned venepuncture site. 13. Venipuncture sites should be carefully assessed for contraindications, such as pain, wounds, decreased circulation, a previous cerebral vascular accident (CVA), dialysis fistulas, or a mastectomy on the same side. It is observed that if the tourniquet is left on longer than 2 minutes, changes in the value of a total protein test occur. 2009 Feb;131(2):195-204. If just a routine coagulation assay is the only test ordered, then a single light blue top tube may be drawn. 8. Do not attempt a capillary puncture more than twice. Wipe away the first drop of blood with a sterile 22 gauze. This guide follows the steps as outlined in the World Health Organizations Guidelines on Drawing Blood: Best Practices in Phlebotomy. with their hand to stabilize it for the draw. It is large and near the skins surface, making it easier for phlebotomists to see before anchoring the vein. Contaminated surfaces must be cleaned with freshly prepared 10% bleach solution. For children over 6 months and adults, the finger is punctured. Gloves are to be worn during all blood collection procedures, and changed betweenpatient collections. What can happen if you vigorously shake the tubes? It is large and near the skins surface, making it easier for phlebotomists to see before anchoring the vein. A. given to the patient Tip: Lowering the arm below the level of the heart may help to engorge the vessels. All approved lancets utilized at Akron Childrens are for single use and feature, Heel punctures are performed on infants less than 6 months of age, or on, older premature infants who are the approximate size of a full-term 6 month, old. 6. UF Health Pathology Laboratories Nontuberculosis Mycobacteria Laboratory, This page uses Google Analytics (Google Privacy Policy), Capillary puncture may be used for obtaining specimens in infants or in adults where. In fact, many search engines provide the option to avoid dangerous sites by turning on a "safer" search. Allow filter paper to air dry for two (2) hours at room temperature. Hematoma formation is a problem in older patients. What Is Venipuncture? Patches of purple or yellow may suggest bruising after a recent venipuncture. Children, particularly under the age of 10, may experience pain and anxiety during the phlebotomy procedure. How many time should you invert them? There are three phlebotomy vein sites located in the arm most utilized by medical professionals and three additional draw sites that are last resorts. } The fluid may dilute the specimen, so collect from the opposite arm.

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what sites should be avoided when performing venipuncture quizlet